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Methotrexate, ectopic pregnancy and bleeding
I have had two doses of Methotrexate administered by a needle. Between doses, the embryo grew from 2.8 cm to 5.8 cm in a span of a week. My Bhcg went from 2600 down to a little over 900. Was at the hospital under observation but have been released. This is my first night home, and I am concerned about what can happen. Experienced a fainting spell while under observation, low blood pressure after, but since then went up. Still ight headed, bleeding light to moderate, bright red, no tissue or clots. Slight cramping in my left side (where ectopic was discovered). Does anyone have any similar experiences or experienced this? What was the outcome? Am I just paranoid, or am I in grave danger at this point? ALL honesty is respected, will not get offended. Thank you
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I have had 2 ectopic pregnancies. One 5 years ago My second on 1/29/2009. For my first I had a laparacospic surgery. But with the scond I had the methrotexate shot. I do not know what to expect I was given the shot on 1/29/09 I have been bleeding since 1/15/09 I still have pain and my doctor said is normal. I have my doubts. I feel nauses, I have diarrhea and sometimes vomit. How long does it take for all this to go away? A couple a days later after having the shot I went to the washroom and notice that something came out but it happenned more than once it hapened about 5 times.  Help I need more info. Thankyou
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Hello everyone,
You don't know how helpful it is to read the experiences of other women who have gone through the same thing as I. I found out I was pregnant while on a trip abroad, I came back to the US and tried getting an appt with my Ob/gyn because of my past history trying to get pregnant and my partially blocked left tube, plus I was recommended for IVF cause I was 32 years old, and not pregnant, even though trying for 3 years.  I was so happy to find out I was finally pregnant, and couldn't wait to have a sonogram to see the baby. I got back to NY and my doctor could not see me until the 8th week of pregnancy ( I guess she figured if it wasn't viable I would just miscarriage.) Well, I was alredy in the 5th week, and feeling like a doctor needed to see me. So I got a new doctor, and she saw me at the 6th week. That's when my doctor found out that my beta HcG level was way too low for that stage of my pregnancy, and explained that one reason could be ectopic. So the sonogram confirmed that there was no fetus where it was supposed to be, but rather in the corner of my uterus.  So my doctor gave me right away a Metho shot, systemic, which was just awful. I got diarrhea, nausea, I could not function and took off from work. 4 days later I got see the sonographer again, and found out that the baby was still alive, there was a fetal heart beat, and I was scared as hell.  So I was given a localized shot right in the uterus of Metho,  This was so painful, I was hospitalized, just for observation because the doctors were afraid it would burst and cause hemorrhaging. I was fine, but my HCG was still 39,000. So since then I have been getting blood work and a sonogram about 2x a week, and the doctors say that everything is going as planned. Today I went to the doctor and the sonogram showed a lot of blood, I could tell the sonographer getting very nervous, but she didn't say anything, running to the doctor to tell him what she saw. The doctor appeared calmed when I met with him, and told me that the linning of the uterus would be coming out, but my dear lord, I never thought I would see what I saw come out of my body just a few hours ago, about 10 days from my second metho shot. The first blood clot was round, and seemed like the fetal sac (i could not see any baby inside), but it was just big and about 3 inches in diameter. A few seconds before it passed I had nausea and I was salivating like crazy, I spit out half a small cup of saliva, which was salty and just watery, not it slimey.I had the most severe cramps just before it happened. I took 3 advils, and had my husband heat up a towel so that I could place it on my belly. That helpef for a few minutes, bu tthe cramping continued, so I went into the tub full of hot water.  That helped but i still had the most excrutiating pain I have ever had. It felt like the pain of 4 periods put together. After my first blood clot passing, I went to lie down on the bed. I stood there for about an hour, and then I had another set of cramps, and I went to the toilet, and right before I sat down, I passed another blood clot. This one was long, about 6 inches, and one side was red like liver meat, the other side was whitish/clear like the insides of the stomach lining. It was so gross, I called my husband to look at it, he was grossed out, but I felt it was imporant for him to see.  
So now I am sitting here and I feel so much better. No more cramps, for now, I hope they stop. It feels like the cycle has been completed, and my uterus feels cleaner and fresher, and I feel like this experience is over.
Well, I feel like my doctors have been wonderful, except for my ob/gyn not been honest about me passing the blood. She specifically said that I would not see a period or blood for 2 months, that my body would just absorb this, which was not true, but now I understand that they possibly say this to you to prevent you from getting scared paranoid about th ewhole experience.
One thing I want to recommend is alternative treatment, such as aromatherapy massage oils. I took a year-long course in aromatherapy, and I decided to make a blend with essential  oils that have abortificent qualities (basil, marjoram, jasmine) and I really feel like massaging the oil on my belly helped.
I hope that all you guys going through this experience work closely with your doctor, and I hope you have good doctors that care about your well-being. Follow-up is so imporant.  Above all, stay positive and trust your inner instincts. My doctor wanted to give me another Metho shot today, and I refused, opting to wait.  
Please heal quickly and pray to whomever you believe in to help you get through this experience.
Warm regards,
NYC Conural Pregnancy
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Hi Everyone,

I got an ectopic pregnancy from my 3rd round of IVF (each time we only get one viable embryo, none to freeze).

My bHCG to test whether the IVF was working or not was 15. They told me "I'm sorry it hasn't worked, but looked like it tried to implant, it's our best result yet" I already knew it hadn't worked as I had my period two days before the test, it lasted a week and was the heaviest I'd ever had.

I had to repeat the test a week later to ensure bHCG had returned to 0. However this test came back at 550, a big rise over 7 days. They requested I book in for an ultra-sound the following Monday which would put me at 6 weeks, and advised it was either an intra-uterine pregancy or ectopic. I thought I might be pregnant with a little trooper that had hung on through my period and was just a bit slow to start. My hopes were rising... This was Monday.

Tuesday I rang them to say I had started bleeding again (period finished Sunday). This was different blood - very thin and very bright red and runny. They said, ok come in for a blood test tomorrow (Wednesday).

Wednesday's result: 605, a rise of 100 since Monday. "Have you got any pain they ask?" Now that you mention it, yes, a dull ache in my right side and a lot of cramping. "Can you come in for an ultra-sound right now?" Yes, I can, I'm now freaking out majorly.

Ultrasound confirms 2.5 cm mass in my right fallopian tube. Devastated! Frightened! I was offered laparoscopy to remove the tube (they wouldn't remove the mass from the tube as they believe the risk of scar tissue and repeat ectopic to be too high) or methotrexate.

So I opted for the methotrexate - only warned of mild symptoms such as nausea, mouth ulcers, diarrhoea. I barely got those after the first shot. This was still Wednesday. (bHCG 605)

Next blood test for Monday March 2: bHCG now 1617. How much has it risen?!! Why isn't it working??!! Was told not unusual for a small rise after the injection... Next blood test & possible second metho shot scheduled for Friday.

Tuesday I can't stand it anymore - I ring and ask for another test to be done on Wednesday - my reasoning is that the pain is worsening and if the metho is working my bHCG should have plateaued or dropped by Wednesday, 7 days after the shot. Otherwise if it's still rising, I need the tube out asap, before I rupture in my sleep.

Wednesday bHCG: 1495 - it's dropped just over 100. Panic abating slightly....
Friday bHCG: 1332 - no-where near enough to get 15% below the base level of 605, so another shot of metho.

Sunday night cramping like you wouldn't believe! (well you girls all probably would) I curled up into a ball and lay on the couch moaning.

It's now Tuesday March 10, 2 days later and it still hurts to walk and my ovaries are throbbing, my whole abdomen hurts, stabbing pains in my bottom. The bleeding is worse and frightening - I sit on the loo and it just drips, every 5 seconds. Some large clots are starting to appear.

I have a theory that the metho didn't work so well first time around because I was taking high dose folate - 1000mg folic acid per day, (IVF reccommendation) and had taken some the day of the first shot (when I was oblivious to the ectopic). Maybe it neutralised a lot of the first dose. They should take this into account when they calculate the dosage of the metho.

So I'm booked in for my 3rd shot this Friday (March 13) but I really really hope I don't need it, especially since the side effects seem to be cumulative.

Bye for now.
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It is so nice to read these stories to know I am not alone.  Others just don't get it!

2/20 I went in for my 5 week sono (after successful IUI) and they saw nothing, I came home from the Dr and I was cramping so bad - they rushed me to a radiologist - saw nothing.  5 sono's on one weekend & nada!  that Wed I had 2 shots of methotrexate.  Felt totally fine for 2 weeks.  Yesterday after my 2 week blood work (levels went down from 1200-450) I was never in so much pain in my entire life!  8 hours straight if massive pain. 3 Tylenol and a heating pad finally put me to sleep.

They don't tell you the cramping would be that bad!  Also, i've been bleeding for 2.5 weeks.  I feel like there should be one big gush (sorry..) is this what I am waiting for?  

Any advice would be great!
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I got my shot on April 2nd and now it is April 18th just this past week I have been having horrible cramping. I actually stopped bleeding after I got the shot. How long does this last?? I know that it isn't so bad that I am having stabbing pains, but it still hurts pretty bad!! Also after the shot I had no cramps until now?? Has anyone else had this??
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Glad to find this site where people are describing there pain after a shot! I was diagnosed with an ectopic pregnancy on April 8th, my beta levels were at 1500.  I had gone to my family doctor because I had bleeding one week on and one week off for the last month.  The hospital discovered a 3.5 cm mass in my right ovary.  I was treated with mexotrexate and sent home.  I was feeling FINE, a bit tired, but nothing to complaine about. However, yesterday (two weeks after the shot) I started bleeding lightly and cramping.  Last night the cramps were so severe (a dull ache in my right ovary, pain radiating down my thigh) that my husband took me to the hospital.  I got another ultrasound and more blood work.  My levels are now down to 110 (awesome!) but the mass has not decreased in size, which kind of worried me (as I DO NOT want to have surgery).  However, the doctor said that it will take time to dissolve, but there is no risk of rupture.  They could not really explain my cramps, but just said it is part of it.   I am still having the pain; it almost feels like a migraine in my ovary????  It helped me to read that you were going through something similar, hope this helps alleviate some of your worries.  Please keep me posted.
(as well...I also stopped bleeding 2 days after the shot)
take care,
lee
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....correction...found a 3.5cm mass in rigt tube, not ovary.
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.....it has been almost 3 weeks since I got the methotrexate shot, my Beta levels as of Friday are down to 28 and I am hoping they will be back to normal by next week.  The ultrasound last week showed that the mass has not decreased in size (still at 3.5cm) and I was curious to know how long it took for your guys masses to dissolve or pass after the shot.  I really want to start exsercising again, but they said to wait until the mass goes down....any input would be appreciated!
Lee
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this is my first time on here first i'd like to say sorry to all who experienced this my story is my levels were low but I was pregant it was only 97 and I was bleed ing i've miss carried twice beofre and have a beautiful 10 year old boy but been trying for a long time to give him a sis or brother so getting back so i thouight i was  mis carrying again which is soo hard to go through we;ll they diagnosed me with ectopic and gave me a shot of metrexerate I haven;t stopped bleeding since the day they i was admitted to the er which at that time treated me for threatening miscarriage well i had to go for blood work twice a week to monitor my levels and everyhting was dropping 97 to 80 to 60 after my third time i thought i was gettig closer to being myself again they told me my levels doubled and rushed me for an exam and a shot methotrexate i;m still bleeding but its sytarting to lighten up I also recieved severe cramping 24hrs after but got better now i have to go tomm to check my levels i;m really scrared i've been bleedign for a total of 3 weeks and my boos are still hurting when will i be the same again and why does my chest still hurt  hope the shot worked thanks for letting me share my story if anyone can help i would greatly appreciate it also i'm not tired but lil appetite
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I was diagnosed with a miscarriage of an ectopic pregnancy on June 11, but it is not in my tubes - it's in the scar of my c-section. I have had 2 rounds of methotrexate. My levels were 44,000 when the first shot was administered 12 days ago and I was down to 12,000 yesterday when they gave me the next two shots. I have had absolutely no bleeding so far. I was 10 weeks along, but the embryo died at about 6 weeks. The doctors don't know much about this type of miscarriage because c-section scar pregnancies are very rare. Just wondering if anyone else has expereinced anything similar. I don't know what to expect. I had no side effects from the first two shots, but today I'm dizzy a lot and having a lot of cramping. The doctors are actually hoping bleeding doesn't start right away because they want the methotrexate to have time to dissolve some of the tissue so that it doesn't rupture the wall of my uterus and cause hemmoraging. There are a couple of surgical options, but they could result in hemmoraging and hysterectomy. We have a one year old son, but we're not ready for the prospect of a hysterectomy! Anybody know anyone who has experienced anything similar? Any insight would be greatly appreciated.
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Reading this forum is freaking me out to say the least.  My experience has been since July 9th 2009 when I began to spot.  I stopped that Sunday and then started again that Wednesday after.  Still bleeding and feeling horrible.  I took a pregnancy test to rule it out but it came back positive so I then called my obgyn b/c I knew something wasn't right.  He found a gestational sac but b/c he could see a yolk or fetal pole could not tell me for certain if it was in my uterus or tube.  I was still spotting.

Had HCG levels drawn that day, and Sat.  He called me Monday and said that from the HCG pattern I probably had a tubal but still not 100%.  Monday night late and into Tuesday, I had bad cramping and bleeding, passed a lot of clots and tissue.  I was certain it was over and I had had my miscarriage.  We to the doc on Wed for another HCG draw and exam. He could no longer find the sac that had been there just the week before and the lining was looking good, thinning back the way it should. So I am thinking, this ***** but atleast it is over.  WRONG.  Another HCG draw and then the call,  your levels aren't going down you have an ectopic.  

So I thought I had miscarried, but no, I have an ectopic.  I was already having fever and chills and just not doing well, when I went into the office two days later when I got that call.  I was also bleeding more.  They found the sac in my left tube.  So I got a dose of Methotrexate, my first one, last Friday.  I got my second dose yesterday b/c the levels while not rising as much, still rising.  I had stopped bleeding earlier this week and really estatic.  A MONTH was really enough.

But as of the past hour I am starting to spot, faint but bright pink blood again.  I am not cramping at this time. Every once in a while will feel a twinge on my left side. But no severe cramping that would indicate I am rupturing.  Has anyone thought they miscarriage and then when the thought it was all over, to find out it had only just begun?  And to read these forums. B/c I have also been told that it will dissolve and now to hear that I may pass it.  It really upsets me.  I am tired of bleeding and just want this over with.  

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I can't believe your story because it is a lot like yours!  We had been trying for over a year and finally got a postitive!  The excitement only lasted two days because I started to spot!  (6 weeks along)  Through the week spotting continued and I was so devestated when I had bad cramping and tons of bleeding I knew I was miscarrying!  Was so extremely hard mentally!  My doc did surgery to remove polups on my cervix 4 days after my miscarriage.  He said he didn't want to do a DandC because its better for your body to do it on its own!  After surgery he said he removed a little bit of tissue but not much just while he was up there.  He told me to take a pregnancy test a week later and if it was negative than nothing to worry about.  My bleeding turned into spotting and I thought this whole ordeal was over...until i took the pregnancy test..POSITIVE!!  Went to the doc...checked my levels every two days..they were going up, so he wanted to see me did an ultra sound found nothing in my uterus...so he guessed I have an eptopic pregnancy..I am so devestated I thought the miscarriage is hard enough and now this.  I get my first Methotrexate shot tomorrow and I am TERRIFIED!! Especially reading about the experience, I feel like its going to be like a miscarriage all over again..it was SOO painful and emotionally hard I don't want to do this all over again!  I am just wondering if I have an eptopic pregnancy what went on with me 3 weeks ago during my "miscarriage" !! I am so down this is so hard and it seems like all my friends are pregnant, and No ONE understands what I am going through!  I wish there was some way that all of us could meet or something!  Ha!  Thanks for your stories and I hope you are all doing well!  So sorry you have to go through this I don't wish this upon anyone!  Melinda..I would love to hear an update from you!  Please tell me what you experienced!  I am terrified for tomorrow!  
LOVE you all!
JP
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Hi Melinda

I have not thought about this site in awhile, but got an e mail update of your post and wanted to re assure you that eventually you will feel normal again.  I went through a very similar experience to yours this past winter.  My husband and I had been trying to conceive for about 8 months and then in February we found out I was pregnant and that same week I started cramping and bleeding and I knew it was a miscarriage (5 -6 weeks along) went to the hospital and they told me it was a complete miscarriage, although hard I was happy not to have to have a D&C….however I continued bleeding on and off for the next 6 weeks and my doctor kept telling me it was to do with the miscarriage.  I decided to go to another doctor who examined me and sent me straight to the emergency for an ectopic pregnancy.  (this was about 6-7 weeks after the first miscarriage).  They told me I needed to have two shots of methotraxate and I was very scarred.  Looking back now, I am relieved that I did not have to have surgery.  I know it is a very emotional time for you right now, but don’t worry too much about the shot, they put one in each of my butt cheeks (lol…my humility went out the window that day)! I bled a bit the week after the shot (trying to remember), but nothing drastic and had a bit of cramping, nothing severe (however, I do get extremely bad periods, so it is hard for me to judge).  It took about 6 weeks for my Beta levels to return to normal and I got my period around the same time.  My periods since the ectopic have been on schedule, but very heavy with lots of clots.  I was trying to figure out how I had lost two pregnancies so close together.  The doctors told me it could have been two causes 1. That the ectopic pregnancy went unnoticed during the first miscarriage (so there were initially two embryos, one miscarried and the other grew in the tubes unnoticed till weeks later) or 2. I had the miscarriage and then got pregnant again two weeks later .  I feel it was the second.
Have you had your thyroid levels checked?
Our stories sound very similar and two months after the ectopic we wanted to start TTC again so I had my blood work done to make sure everything (esp. my folic acid levels) were back to normal and that’s when I found out I have a severely underactive thyroid that most definitely contributed to the miscarriage.  I’ve been dealing with that now for the last few months, my thyroid levels finally went back to normal last week, so we are going to start trying again soon.
I have learned a lot this past year, mostly that you can not plan for the big things in life, sometimes you just have to let it go and accept that it will happen when it happens and how much more we will appreciate it when it does.  
If you have any questions please feel free to ask, it definatley helps to talk about it and not everyone understands.  

Take Care today!!
Leanne
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sorry meant to direct my post to JP, but happy if anyone else can relate
Lee
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hello, I had an ectopic "cervical" pregnancy that was ended because of how low it was.  I was not given much time to think of it because apparently I was in danger.  They gave me a methotrexate injection under anestecia and I had a second intervention 2 days later for another injection of (potassium or something like it) to stop the heartbeat of the fetus.  I was told that if nothing progressed I would need a second methotrexate injection.  A week after, I had left the hospital and was under observation by my dr.  regular blood tests for hcg are taken weekly my 2 last ones went from 7 000 to 800 Ive had 2 major "excrutiating" cramps/abdominal pains in which a great amount of blood is passed, no clots just almost liquidy.  I am taking some paracetamol during this times and breathing as if I was given birth..or so I guess as this is my first.  I have dr appointments almost every week to 10 days in which they do a sonogram to check the status, it had diminished but still there.  Because my case is apparently "rare" and it is situated very low, they are afraid of a hemorrage so I am to call/got to the hospital if abundant bleeding is present.  It has helped to read this as you tend to feel lost and like a total failure.  But I wanted to share some information with everyone.  You will feel severe pain, take the meds they prescribe and have them handy.  Keep active but also take it easy, there are lots of changes going on inside.  The last case I was told as mine took 6 months for her to release everything.  My case does not allow for D&C, or any other removal as it can be "dangerous".  Trying to avoid a hysterectomy.  I guess everyone's body is different, I hope my situation does not take 6 months.  I hope I get to release everything in less time.  I try not to think of the little angel I lost, but focus on a better next time.  I wish everyone strength.  By the way, Im in europe, Im sure they do everything different over here but so far I have been told pretty much what to expect, oh yes, I had a list of questions as I had to translate...it hasn't been easy.  I hope I never have to go through this again.  
LostinEurope
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Thank you so much for commenting on this.  I have never done one of these message board things so I think it is pretty awesome to have other people who know what I am going through to an extent.  So since the last time I have written I got a shot of methotrexate and a week later checked my HCG levels and they had only gone down a about 200 so they sent me back and I got another injection on friday and I have to go tomorrow for blood work and if my levels have not changed enough I might have to get surgery (laproscopy) and have the fetus/tissue removed.  The shots have not done anything for me.  I have not felt any difference, infact my bleeding has almost near disappeared in the last few days.  I am really frustrated because I just want this all to be over!  Also I am nervous because I have been told that the surgery has a risk of loosing your falopian tube??  I don't want that to happen because I have already had a hard time getting pregnant I don't want to cut my chances in half!!!  Has anyone else every had methotrexate not work for them??  Thanks for the advice about thyroid..I would have never thought about that!  Hope all is well and thank you again!
JP
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Hi JP,

Im sorry you had to go back for another shot.  I am trying to remember how long it took for my levels to return to normal and what rate they decreased at.  I think it took about 6-7 weeks for them to get below 5.  I believe I have the numbers at home, i will have a look and get back to you, but dropping 200 in a week sounds similar ??? I also remember thinking I would have a lot of bleeding, but I didn't either.  The doctor told me not to expect bleeding like you would with a miscarriage because your uterus is not shedding, rahter the shot just breaks up the mass in your tube.  I hope your results tomorrow are better than lastweek.  

Leanne
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Good luck with the shot tomorrow!  I luckily just had to have one, but the side effects were HORRIBLE!  If I ever have to choose something like that again, I'll opt for the laparoscopy, which I've had in the past as well, for cysts.  My bleeding has finally stopped, I bled for nearly 1 1/2 months!  Ugh!  Now I'm starting to feel better too, hooray!  I wish you all the best, let us know how tomorrow goes, what are your HCG levels?  I still have to go for one more blood test this week, but I'm sure I'm at zero now.  Take care.  I plan to have that fallopian tube xray done next month, HSG??  Hopefully they're clear, or they find something to fix....and fix it!
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Hi JP,

I found the calendar I had used to track the decline of my BETA levels once I was given the Methorexate shot.  Hope this is helpful:
week one: ectopic found, shot given, Beta levels at 1400
week two : Beta level 562
week three:  Beta Level 120
4 days later:  Beta level 28

Everyone is different though, but I know when I was going through this it was helpful to read about other people's experiences.  Hope you are doing alright.

Leanne
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Thanks for writing!  So i went and I got my levels checked and they went down almost by half!!  I was at 956.  YAY i am so relieved! So I go tomorrow and hopefully they will still be going down!!  BUT thanks to you ladies who answer my questions i have some more for you!  The dr. office didn't really tell me what the next step is, the nurse just said: "looks like they are going down so that's good! Go in and get it checked again and if it is still going down then you should be ok."  So I am just wondering if there is any follow up things I need to be checked for like you KAagson you are having a falopian tube XRay??  They have said nothing to me about any follow up things.  I feel like it wasn't just a fluke thing that I am having an eptopic prenancy and I have researched that there are reasons behind them...I would hate to go through this all over again just to then figure out my problem???  PLEASE HELP if you know anything??  ONce again thank you thankyou thankyou for helping me!
LOVE YOU ALL
JP
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